Etanercept response clusters identified in patients with JIA
medwireNews: Researchers have found that children and young people with juvenile idiopathic arthritis (JIA) can be categorized into five different groups according to their response to etanercept treatment.
“Finding these clusters could be useful for forecasting of disease, communication between families and healthcare professionals, and identifying treatment needs,” Stephanie Shoop-Worrall (The University of Manchester, UK) told delegates at the EULAR 2021 Virtual Congress.
The team analyzed UK registry data from 1003 children and young people with JIA (median age 12 years) who initiated etanercept for the first time before January 2019, and evaluated treatment response according to the four components of JADAS: active joint count; physician global assessment; parent/guardian global assessment; and erythrocyte sedimentation rate (ESR).
Using multivariate group-based trajectory models, Shoop-Worrall and colleagues identified five clusters of response trajectories based on these measures.
In the first cluster, including 16% of patients, there was rapid improvement in all JADAS measures following etanercept initiation, whereas patients in the second cluster (10% of the study population) experienced slow improvement in all measures. The presenter said that there were “persistently raised” physician global scores in the third cluster (7%) and parent global scores in the fourth cluster (30%). And in the fifth cluster, involving the largest number of patients (37%), there was “persistent disease across all measures,” she reported.
Shoop-Worrall said that there were “striking similarities” between these etanercept response clusters and previously identified clusters for methotrexate response, despite the drugs having a different mechanism of action.
The researchers also identified some factors associated with the different etanercept response clusters. For instance, younger age was significantly associated with being in the rapid improvement cluster, while lower ESR levels were significantly associated with having persistently high parent global scores.
“We also found similar characteristics between the clusters of methotrexate and etanercept response,” said Shoop-Worrall.
She concluded that the response clusters may represent “a new framework for understanding treatment response beyond the existing response/non-response paradigm.”
And she added: “Understanding the factors underpinning these clusters would really aid stratified treatment of JIA.”
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